Deregulate DTCA
Re: ‘If drug advertising restrictions are loosened, how should marketers respond?’ (‘Counter Strategy,’ Sept. 22/03, p. 2)
As an advertiser who has worked with the pharmaceutical industry for 15 years, I wish to respond to Dr. Mintzes, who paints a negative picture in her recent study, published in the Canadian Medical Association Journal of the arrival of direct-to-consumer advertising.
Dr. Mintzes concludes if a patient brings up DTCA with a physician, it is highly likely that a prescription will result. This implies that doctors feel pressured into prescribing medication without being certain about it. Other studies, however, have clearly demonstrated that this is not the case.
In a 1999 study, Dr. Spurgeon reported that, when questioned about the impact of DTCA on their prescription habits, doctors said they felt ‘little’ or ‘very little’ pressure from their patients. In fact, only 6% of the 200 GPs surveyed felt strongly pressured. Despite this, all the doctors questioned, who opted for the medication patients requested instead of their usual choices, agreed that the treatments prescribed were totally acceptable.
In her study, Dr. Mintzes states that only 12.4% of doctors surveyed would ‘definitely’ prescribe the same medication again instead of their usual choice. She arbitrarily concludes that 50% of doctors would be ambivalent in choosing the same medication again. In a recent communication with Dr. Mintzes, I learned that, in fact, only 8% of the doctors would not have opted for the same medication again.
If, contrary to her method, the number of doctors who would ‘very likely’ prescribe the same medication again was added to the number who said they would ‘possibly’ do it again, as indicated in the study (and not with the number who would ‘possibly not’ do so, as suggested by Dr. Mintzes), 92% of physicians would have chosen the advertised drug again.
DTCA has also been shown to be informative. A 1997 study involving 454 family doctors concluded that DTCA encouraged patients to take an active role in managing their health and led them to seek advice about problems they would have otherwise ignored. Moreover, being better informed increases compliance with treatment, as shown in a study published in Drug Topics in 1999.
Opponents of DTCA have never succeeded in demonstrating that the costs generated by the increase in patients who obtain prescriptions for a promoted drug are higher than the savings obtained by reducing inherent health service fees (hospital costs, for example).
DTCA of prescription medicines is already a reality in Canada because of cable, etc. Updating and clarifying regulations in a way that takes this reality into account and gives it direction is not only necessary, but also urgent.
Properly defined, regulations can benefit everyone: Health Canada, which would have a clearer basis to work from that would be easier to enforce; the [drug] industry, which would know where it stood; the public, which would have more information and know where the information came from; and the medical community, which the [drug] industry would help to prevent certain pathologies and promote compliance with treatment, thereby reducing the long-term pressure on the health-care system.
Marc Lacroix, President and CEO, LXB Communication Marketing, Quebec City
